Abstract

With up to 56% of individuals taking diuretics likely to develop hypokalemia, and comorbid disease and many other types of medications having the potential to induce hyperkalemia, potassium abnormalities are some of the most commonly seen electrolyte abnormalities in the emergency department (ED). Unless recognized and treated appropriately, they can also be some of the most deadly. Symptoms accompanying potassium abnormalities are often vague, involving multiple organ systems. This evidence-based review discusses the etiology, differential diagnosis, and diagnostic studies for detecting hypokalemia and hyperkalemia, including managing laboratory errors that lead to factitious potassium findings. Recognition and treatment of life-threatening dysrhythmias in hypokalemia and hyperkalemia are key to managing these potassium abnormalities. Electrocardiogram (ECG) findings, treatment algorithms, and controversies on treating potassium abnormalities in the ED are discussed, with recommendations on criteria for disposition.

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Authors

Pepin J, Shields C

Institution

Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY, USA.

Source

Emergency medicine practice 14:2 2012 Feb pg 1-17; quiz 17-8

MeSH

Algorithms
Arrhythmias, Cardiac
Calcium Chloride
Decision Trees
Diagnosis, Differential
Drug Therapy, Combination
Electrocardiography
Emergency Service, Hospital
Emergency Treatment
Evidence-Based Medicine
Humans
Hyperkalemia
Hypoglycemic Agents
Hypokalemia
Insulin
Magnesium
Male
Middle Aged
Potassium Chloride
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Renal Dialysis
Risk Factors
Treatment Outcome
Water-Electrolyte Imbalance

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22413702